Abstract This study identifies the effect of the public policy implemented in the State of Ecuador in 2008 in regard to democratization of access to higher education, being understood as a right that reduces the existing gaps between men and women, ethnicities and quintiles; for this purpose, a mixed methodology is used as the starting point and, using a qualitative analysis, a review of the main legal instruments regulating higher education in Ecuador was performed, along with specific articles related to this subject. For quantitative methodology, the starting points were reports of the National Information System (SNI) in regards to net rate of enrollment in higher education, managed by the National Secretariat of Planning in order to perform a descriptive analysis on its evolution in gender, ethnicity and registration quintiles. Among the main results obtained, it was determined that the gratuity policy did have a positive effect for access to higher education for men, women, African-Ecuadorian and indigenous peoples and, for quintiles 1, 2 and 3 until year 2011, a noticeable increase was seen in nationwide net rate of enrollment with 4.95 percentile points between 2007 and 2011, until the meritocracy policy entered in force in 2012.

Resumen Esta investigación identifica el efecto de la política pública implementada en 2008 por el Estado ecuatoriano referente a la democratización del acceso a la educación superior, entendida como un derecho que reduce las brechas que existen entre hombres y mujeres, etnias y quintiles; para ello, se parte de una metodología mixta, en la que, dentro del análisis cualitativo, se revisan los principales instrumentos legales que regulan la educación superior en Ecuador, y artículos seleccionados sobre la temática. En la metodología cuantitativa, se parte de los reportes del Sistema Nacional de Información (SNI) referentes a la tasa neta de matrícula en educación superior, administrado por la Secretaría Nacional de Planificación, para realizar un análisis descriptivo sobre su evolución a nivel de sexo, etnia y quintiles de ingreso. Entre los principales resultados, se determina que la política de gratuidad tuvo un efecto positivo en el acceso a la educación superior, para hombres, mujeres, afroecuatorianos e indígenas, y en los quintiles 1, 2 y 3, hasta el año 2011, evidenciando un incremento en la tasa neta de matrícula a nivel nacional, de 2007 a 2011, de 4,95 puntos porcentuales, hasta que entró en vigor la política de meritocracia, en 2012.

Resumo A investigação identifica o efeito da política pública implementada no ano 2008 pelo Estado equatoriano em relação à democratização do acesso à educação superior, entendida a jeito de direito que reduze as divisões existentes entre homens e mulheres, etnias e quintis; para esse propósito, usou-se uma metodologia mista na que, dentro da análise qualitativa, examinaram -se os instrumentos legais principais de regulação da educação superior no Equador, além de artigos escolhidos da área temática. Dentro da metodologia quantitativa, usaram-se os reportes do Sistema Nacional de Informação (SNI) referentes à taxa líquida de matrícula na educação superior aportado pela Secretaria Nacional de Planificação, para fazer uma análise descritiva da evolução em relação ao sexo, etnia e quintis de admissão. Entre os resultados principais, determinou-se que a política de gratuidade teve um efeito positivo no acesso à educação superior para homens, mulheres, afro-equatorianos e indígenas e, nos quintis 1, 2 e 3, até o ano 2011, observou-se um incremento na taxa líquida de matrícula ao nível nacional entre os anos 2007 ao 2011, com 4.95 pontos percentis, até o começo da validade da política de meritocracia no 2012.

SUMMARY OBJECTIVE: This study was conducted to determine the effect of relaxation exercise on fatigue symptoms in hemodialysis patients. METHODS: This is a meta-analysis study. The literature review was carried out by searching studies published between 2011 and 2020. This meta-analysis was recorded on PROSPERO in the National Health Research Institute (Registration no: CRD42022313646). RESULTS: Seven studies meeting the inclusion criteria were included in the meta-analysis. The effect size of the studies included in the meta-analysis was found to be g=1.232 (p=0.028), which indicated a "huge effect size." The scale used in the subgroup analyses, the application time of the relaxation exercise, and the number of relaxation exercise applications were evaluated, and a significant difference was found at p<0.05. CONCLUSION: Relaxation exercises can be used as an effective method for reducing fatigue in hemodialysis patients. OBJECTIVE patients METHODS metaanalysis meta analysis 201 2020 Registration no CRD42022313646. CRD42022313646 CRD . CRD42022313646) RESULTS metaanalysis. analysis. g1232 g 1 232 g=1.23 p=0.028, p0028 p p=0.028 , 0 028 (p=0.028) huge size. analyses evaluated p005 05 p<0.05 CONCLUSION 20 202 CRD4202231364 g123 23 g=1.2 p002 p=0.02 02 (p=0.028 p00 p<0.0 2 CRD420223136 g12 g=1. p=0.0 (p=0.02 p0 p<0. CRD42022313 g1 g=1 p=0. (p=0.0 p<0 CRD4202231 g= p=0 (p=0. p< CRD420223 p= (p=0 CRD42022 (p= CRD4202 (p CRD420 CRD42 CRD4

BACKGROUND. The Health Professions Council of South Africa implemented a compulsory research component for specialist practitioner registration through the Master of Medicine (MMed) degree in 2011, eliciting both commendation and critique. Chief among the concerns is the extended time required for MMed completion. This study explores the duration of each component of the MMed research thesis and discusses the potential problematic areas in terms of its timeous completion, about which there is currently a lack of data, with particular regard to the South African (SA) setting. OBJECTIVES. To quantitatively delineate the various components of the MMed research thesis process, identify potential barriers to its completion, and formulate a recommended evidence-based proposed timeline allowing for successful and timeous completion of the MMed. METHODS. We conducted a retrospective review of MMed degrees completed by paediatrics registrars at the University of the Witwatersrand, Johannesburg, SA, from 1 January 2011 to 31 December 2018, and an electronic survey of former MMed students, detailing the duration of each of the components of the MMed research thesis process. RESULTS. The survey had a 70.5% response rate (n=148 respondents, of whom 141 fully completed the survey). The median (interquartile range) time to complete the MMed research thesis was 30 (21 - 42) months. While 78.0% of respondents deemed 4 years adequate for completion, 15.6% reported durations exceeding 4 years, and 2.1% had not completed the MMed. The components of the research thesis with the longest duration in terms of completion included development of a first draft of the research protocol, data analysis, and development of the first draft of the final report. Factors reportedly associated with successful completion of the thesis were a supportive supervisor and the provision of a research rotation. CONCLUSION. A significant portion of candidates do not complete the MMed research thesis within the 4-year training period, hindering specialist registration. The major contributing factors appear to be related to candidates' inexperience regarding the research process and lack of exposure to it, as well as some of the administrative procedures involved. Utilisation of the recommendations and structured timeline will help identify problematic areas timeously and ensure successful completion of the thesis.

SUMMARY OBJECTIVE: This randomized clinical trial study aims to investigate the effects of antioxidant food supplementation on the total antioxidant capacity of seminal plasma, sperm DNA fragmentation, sperm chromatin quality, and semen parameters. METHODS: In this study, a total of 48 subfertile men with moderate physical activity were included. Group 1 was recommended to use the antioxidant supplements, while antioxidant food supplements were not given to Group 2. Total antioxidant capacity, sperm DNA fragmentation, sperm chromatin structure, hormone levels, physical activities, and semen parameters were evaluated before and after treatment. Total antioxidant capacity, sperm DNA fragmentation, and sperm chromatin structure were assessed using ELISA, transferase dUTP nick end labeling, and aniline blue staining, respectively. RESULTS: Sperm DNA fragmentation (p=0.003) and histone/protamine ratio (p<0.001) were significantly decreased in the patients receiving antioxidant treatment. There was no statistical difference in the total antioxidant capacity values of the post-treatment groups. CONCLUSION: Antioxidant therapy seems to improve sperm DNA fragmentation and histone/protamine ratios in subfertile patients. Clinical Trial Registration Number: NCT06042738. OBJECTIVE plasma quality METHODS 4 included 2 levels activities treatment ELISA labeling staining respectively RESULTS p=0.003 p0003 p 0 003 (p=0.003 histoneprotamine histone protamine p<0.001 p0001 001 (p<0.001 posttreatment post groups CONCLUSION Number NCT06042738 NCT p=0.00 p000 00 (p=0.00 p<0.00 (p<0.00 NCT0604273 p=0.0 p00 (p=0.0 p<0.0 (p<0.0 NCT060427 p=0. p0 (p=0. p<0. (p<0. NCT06042 p=0 (p=0 p<0 (p<0 NCT0604 p= (p= p< (p< NCT060 (p NCT06 NCT0

Studies offering curriculum framework for institutional internalisation of criminology and forensics studies and Work-Integrated Learning (WIL) within the Criminal Justice System (CJS) are scarce. This article gives a scoping review of these concepts, which are currently presented separately, as they are from distant study fields. As a result, the objective of this article is to establish the current link between criminology and forensic studies to enhance the South African CJS and Higher Education Institutions (HEIs) curriculum frameworks, while integrating theory and practice. This qualitative scoping review was supported by the adapted version of methodology framework by Arksey, Hilary and O'Malley, Lisa of 2005 to search for approximately 9 031 relevant studies from fundamental databases and 139 000 internet sources focusing on South African context and other international countries. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for data analysis, coupled with the inductive Thematic Content Analysis (TCA). This article confirmed that combining forensic criminology features could transform the South African CJS and HEIs offerings. For recommendations, the Qualifications Board should expedite the registration of forensic criminology as a profession consisting of professional qualification, guided by ethical and disciplinary rules. Overall, limited prioritisations, slow registration process to a "Scientific Board" and advancement of this discipline negatively affect immediate responses to achieve the WIL. The knowledge, attitudes, skills and values gained during participating in the South African Future Professors Programme (FPP) Phase 2 Cohort 1 2022-2023 offered contributions to the field of professorship thereof.

Abstract Introduction: a blood transfusion is a therapeutic procedure that involves the administration of blood or its derivatives, in order to correct hematological disorders, restore hemodynamic balance or improve tissue oxygenation. It is carried out under strict protocols in order to minimize the risks of adverse transfusion reactions, considered as an unwanted and unexpected response associated with blood transfusion. Methods: descriptive study of 13,925 patients in which 67 people presented a transfusion reaction between the years 2020 to 2022. A secondary source of information was used from which the demographic and clinical variables and patients reported with transfusion reactions were taken. The information was analyzed with absolute and relative frequencies and their 95% confidence interval. Results: during 2020-2022, 67 adverse reactions related to the transfusion of 53,418 blood components were reported. Allergic reactions were the most common 85.07% (95% CI 74.26-92.60). Regarding the severity of the reaction, most people had a mild reaction 63.64% (2020), 81.50% (2021), 79.30% (2022). The prevalence for the female sex was higher 63.64%, 59.3% and 62.1% and for the age of people between 18 to 59 years old 54.55%, 44.44% and 37.9% respectively. Conclusion: blood transfusion plays a crucial role in various clinical contexts. Worldwide, adverse events affect between 1% and 3% of transfused patients. In Colombia, they affect 0.12%, the same as in this study where 0.12% presented an adverse transfusion reaction. This shows an under-registration at the national level, raising questions about their quality and timeliness.

Resumen Introducción: una transfusión de sangre o sus componentes, con el fin de corregir trastornos hematológicos, restaurar el equilibrio hemodinámico o mejorar la oxigenación tisular se lleva a cabo bajo estrictos protocolos con el fin de minimizar los riegos de las reacciones adversas transfusionales, consideradas como una respuesta indeseada e imprevista asociada a la transfusión sanguínea. Métodos: estudio descriptivo de 13925 pacientes en el que 67 personas presentaron alguna reacción transfusional entre los años 2020 a 2022. Se utilizó una fuente de información secundaria de la cual se tomaron las variables demográficas, clínicas, pacientes reportados con reacciones transfusionales. La información se analizó con frecuencias absolutas, relativas y su intervalo de confianza del 95%. Resultados: durante el 2020-2022 se reportaron 67 reacciones adversas relacionadas con la transfusión de 53.418 hemocomponentes. Las reacciones alérgicas fueron las más comunes 85.07% (IC 95% 74.26-92.60). En cuanto a la severidad de la reacción la mayoría de las personas presentó reacción leve 63.64% (2020), 81.50% (2021), 79.30% (2022). La prevalencia para el sexo femenino fue mayor 63.64%, 59.3% y 62.1% y para la edad las personas entre 18 a 59 años 54.55%, 44.44% y 37,9% respectivamente. Conclusión: la transfusión sanguínea desempeña un papel crucial en diversos contextos clínicos. A nivel mundial, los eventos adversos afectan entre el 1% y el 3% de los pacientes transfundidos, en Colombia, afecta al 0,12%, igual que en este estudio donde el 0,12 % presentó reacción adversa transfusional. Lo que evidencia un subregistro a nivel nacional planteando interrogantes sobre la calidad y oportunidad de éstos.

Abstract Introduction: professional codes of ethics should be updated periodically to respond to criticisms and demands arising from social, technological and scientific changes, especially in the field of human rights; Objectives: to verify the updating of the new Brazilian Code of Medical Ethics in the field of bioethics and human rights; Methods: document analysis of a document in the public domain, with previous definition of categories of analysis and registration units, with reference to the Unesco Universal Declaration of Bioethics and Human Rights. Results: the analysis showed the following most prevalent principles: dignity, autonomy, respect for human vulnerability and personal integrity, benefit and harmful effects, solidarity, privacy and confidentiality, non-discrimination and non-stigmatization; Not very well covered: people without the capacity for consent, social responsibility, protection of the environment and future generations; Absent: sharing of research benefits, equality, justice and equity, respect for cultural diversity and pluralism; Final considerations: the Brazilian Code of Medical Ethics values the maintenance of prudential autonomy in the relationship with patients and health professionals. The inclusion of broader social concerns, in a fragmentary and insufficient way, does not yet ensure the broad defense of public health, and the rights of people in vulnerability, who have historically been in a position of disparity. The application of the method in a specific context, of the pandemic, was useful for the understanding of the deontological and principlist limits applied to public health. A future revision is suggested based on Unesco's Universal Declaration of Bioethics and Human Rights and the deliberative method for interprofessional decision-making.

Resumo Introdução: os códigos profissionais de ética devem ser atualizados, periodicamente, para responder às críticas e demandas decorrentes de mudanças sociais, tecnológicas e científicas, especialmente no campo dos direitos humanos; Objetivos: verificar a atualização do novo Código de Ética Médica brasileiro ao campo da bioética e dos direitos humanos; Métodos: análise documental de documento de domínio público, com definição prévia de categorias de análise e unidades de registro, tendo como referencial teórico a Declaração Universal de Bioética e Direitos Humanos da Unesco. Resultados: a análise demonstrou como princípios mais prevalentes: dignidade, autonomia, respeito à vulnerabilidade humana e a integridade pessoal, benefício e efeitos nocivos, solidariedade, privacidade e confidencialidade, não discriminação e não estigmatização; pouco contemplados: pessoas sem capacidade de consentimento, responsabilidade social, proteção do meio ambiente e das gerações futuras; ausentes: repartição de benefícios da pesquisa, igualdade, justiça e equidade, respeito à diversidade cultural e ao pluralismo; Considerações finais: o Código de Ética Médica brasileiro preza pela manutenção de uma autonomia prudencial na relação com os pacientes e profissionais da saúde. A inclusão de preocupações sociais mais amplas, de forma fragmentária e insuficiente, não assegura ainda a ampla defesa da saúde pública, e dos direitos das pessoas em vulnerabilidade, situadas historicamente em posição de desigualdade. A aplicação do método em contexto específico, de pandemia, foi útil para a compreensão dos limites deontológicos e principialistas aplicados à saúde coletiva. Sugere-se uma futura revisão tendo como eixos a Declaração Universal de Bioética e Direitos Humanos da Unesco e o método deliberativo para tomada de decisões interprofissionais.

Abstract: In this paper we analyze several laws that are framed into the so-called cultural policies of the Province of Chaco (Argentina). We relied primarily on Cultural Studies and related theoretical approaches. Specifically, we are concerned about language that includes a distinctive otherness: the indigenous peoples. We argue that public discourse, which is reflected in a variety of laws, refers to indigenous peoples in terms of radical “othering”. We inquire whether this language, which constantly refers to otherness through exoticization, is a potential threat to the same diversity that it claims to promote. While it emphasizes the existence of “three ethnic groups” in the province, it invisibilizes other groups that do not share the standard stereotypical features of indigenousness. We will focus on two issues: the invisibilization produced by the “othering” and the obsession with registration and patrimonialization of cultural expressions. Based on our solid assumption about the political character of languages, we conclude with a critical review of multiculturalism as a discursive formation in provincial laws that refer to or denote the “culture” of local aboriginal peoples.

Resumen: Inspirados fundamentalmente en los estudios culturales y corrientes teóricas afines, hacemos un recorrido general por algunas leyes que se enmarcan en las llamadas políticas culturales en la provincia de Chaco (Argentina). Nos interesa analizar, puntualmente, el lenguaje que refiere a una forma especial de alteridad: los pueblos indígenas. Entendemos que el discurso estatal que se plasma en diversas leyes refiere a los pueblos originarios desde una perspectiva de la “otrerización” radical. Nos preguntamos si este lenguaje, que refiere a la alteridad siempre desde la exotización, no es una amenaza para la propia diversidad que pretende reivindicar, ya que -mientras destaca la existencia de “tres etnias” en la provincia- invisibiliza otros grupos menos coincidentes con los aspectos estereotipados de lo indígena. Nos centramos en dos tópicos principales: la invisibilización que produce la otrerización y la obsesión por el registro y la patrimonialización. Con la firme convicción del carácter político de los lenguajes, concluimos con una revisión crítica del multiculturalismo como formación discursiva a través de las leyes provinciales que hablan, refieren o denotan a la “cultura” de los pueblos originarios locales.

Abstract: This article seeks to analyze the relationship between health and housing in state-produced housing complexes. A case study is conducted on the Parque Sur and Huarpes II neighborhoods, which are more than 40 years old and are located in the municipality of Godoy Cruz (Mendoza Metropolitan Area, Argentina). These neighborhoods are a reflect of two periods in Argentinian history: the last military dictatorship and the restitution of democracy. The study is conducted considering the dimensions established in the WHO Guidelines on Housing and Health (PAHO, 2022) and community social capital based on the Diagnostic Methodology for the Determination of Health Risk of Households in Housing (DRVS), whose intellectual property registration is CONICET/UTN-FRC (2021). The assessment is carried out by showing the structural processes that housing policies generate in the health of the households that inhabit the houses, highlighting the threats they are exposed to. In this sense, it is about avoiding hegemonic games that denounce without revealing and inform without mobilizing, based on isolated factors from the problem.

Resumen: En este artículo se busca analizar la relación entre salud y vivienda en conjuntos habitacionales de producción estatal. Se realiza un estudio de casos con los barrios Parque Sur y Huarpes II, que tienen una antigüedad de más de 40 años y están ubicados en el municipio de Godoy Cruz (Área Metropolitana de Mendoza, Argentina). Estos barrios son característicos de dos períodos: la última dictadura militar argentina y la restitución de la democracia. El estudio se realiza considerando las dimensiones establecidas en las Directrices de la OMS sobre Vivienda y Salud (OPS, 2022) y el capital social comunitario en base a la Metodología Diagnóstica para la Determinación del Riesgo para la Salud de los hogares en la vivienda (DRVS), cuyo registro de propiedad intelectual es de CONICET/UTN-FRC (2021). La valoración se realiza mostrando los procesos estructurales que las políticas habitacionales generan en la salud de los hogares que habitan las viviendas poniendo en evidencia las amenazas a las que están expuestas. En este sentido, se trata de evitar juegos hegemónicos que denuncian sin revelar e informan sin movilizar fundados en factores aislados de la problemática.

Abstract: The digitalisation processes have substantially modified the modes of production and consumption of goods and services in society as well as the different interactions of which we are part. States and their interventions have not been left out of these processes. The covid-19 health pandemic situation -although it had been brewing previouslyhas accelerated the use of Information and Communication Technologies (ICTs) in the management and implementation of public policies in general and social policies in particular. Within this framework, the aim of this paper is to identify -in an exploratory mannerdoubts, expressions about the registration process and view on three income transfer or income guarantee policies that have emerged in the context of the covid-19 health pandemic in Argentina and Spain. Based on virtual ethnographies in groups of recipients in the social network Facebook, the cases of analysis are taken as cases of Emergency Family Income and Food Reinforcement in the Argentinean case and Minimum Living Income in Spain. We have sought to explore some dimensions of the process of programme implementation -which was managed virtuallyin order to understand the difficulties faced by the potential beneficiaries of these policies. The results obtained aim to demonstrate -without claiming to be exhaustivepossible potentialities and limitations offered by digitisation processes in policies to combat poverty and social exclusion.

Resumen: Los procesos de digitalización han modificado sustancialmente los modos de producción y consumo de bienes y servicios en la sociedad, así como las diferentes interacciones de las que somos parte. Los estados y sus intervenciones no han quedado por fuera de estos procesos. La situación de pandemia sanitaria por covid-19 -aunque ya se venía gestando previamente-, ha acelerado el uso de las Tecnologías de la Información y la Comunicación (TIC’s) en la gestión e implementación de políticas públicas en general y sociales en particular. En este marco, el objetivo de este escrito es identificar -de modo exploratoriodudas, expresiones en torno al proceso de inscripción y miradas sobre tres políticas de transferencias de ingresos o garantía de ingresos, emergentes en el contexto de pandemia sanitaria por covid-19 en el estado argentino y español. A partir de etnografías virtuales en grupos de personas receptoras de la red social Facebook, se toman como casos de análisis el Ingreso Familiar de Emergencia y el Refuerzo Alimentario en el caso argentino y del Ingreso Mínimo Vital en España. Se ha buscado explorar algunas dimensiones del proceso de implementación de programas -cuya gestión se realizó de manera virtualen pos de comprender las dificultades a las que se enfrenta la población potencialmente receptora de estas políticas. Los resultados obtenidos pretenden demostrar -sin pretensión de exhaustividadposibles potencialidades y limitaciones que ofrecen los procesos de digitalización en las políticas de lucha contra la pobreza y la exclusión social.

Resumen La presente contribución propone abordar al registro como herramienta metodológica situada en el ámbito de la extensión universitaria y en relación con los procesos de aprendizaje en los dispositivos. El objetivo es, por un lado, presentar las principales características de la construcción de registros de las experiencias a lo largo de las prácticas de extensión, sus alcances y limitaciones. Por otro lado, reflexionar sobre las instancias pedagógicas donde realizamos la lectura de esos registros, un “descentramiento teórico” en que nos permiten establecer asociaciones, formular preguntas impensadas, generar hipótesis. Dos momentos que se retroalimentan. En este sentido, consideramos que el registro es una herramienta metodológica de sumo valor cognoscitivo que permite recuperar las experiencias y se convierte en materia prima para la interpretación y análisis de esos procesos, en diálogo con la teoría a través de instancias de escritura.

Abstract The present contribution proposes to approach registration as a methodological tool situated in the field of university extension and in relation to learning processes in the devices. The objective focuses, on the one hand, on presenting the main characteristics of the construction of records of experiences throughout extension practices, their scope and limitations. On the other hand, to reflect on the pedagogical instances where we read those records, a “theoretical decentering” that allows us to establish associations, formulate unanticipated questions, generate hypotheses. Two moments that mutually feed back. In this sense, we consider registration to be a methodological tool of great cognitive value that allows us to recover experiences, and becomes raw material for the interpretation and analysis of those processes in dialogue with theory through writing instances.

Resumo A presente contribuição propõe abordar o registro como uma ferramenta metodológica situada no âmbito da extensão universitária e em relação aos processos de aprendizagem nos dispositivos. O objetivo se centra, por um lado, em apresentar as principais características da construção de registros das experiências ao longo das práticas de extensão, seus alcances e limitações. Por outro lado, refletir sobre as instâncias pedagógicas onde realizamos a leitura desses registros, um “descentramento teórico” que nos permite estabelecer associações, formular perguntas inesperadas, gerar hipóteses. Dois momentos que se retroalimentam mutuamente. Neste sentido, consideramos que o registro é uma ferramenta metodológica de notável valor cognitivo que permite recuperar as experiências e se torna matéria-prima para a interpretação e análise desses processos em diálogo com a teoria através de instâncias de escrita.

Abstract Background Recently, it was demonstrated that allopurinol, a xanthine oxidase inhibitor, has cardiovascular and anti-ischaemic properties and may be a metabolic antianginal agent option.Objective: The objective of this study was to evaluate the antianginal effect of allopurinol as a third drug for patients with stable coronary artery disease (CAD). Methods This was a randomized clinical trial between 2018 and 2020 including patients with CAD who maintained angina despite initial optimization with beta-blockers and calcium channel blockers. The individuals were randomized 1:1 to 300 mg of allopurinol twice daily or 35 mg of trimetazidine twice daily. The main outcome was the difference in the angina frequency domain of the Seattle Angina Questionnaire (SAQ-AF). A probability (p) value < 0.05 was considered statistically significant. Results A hundred and eight patients were included in the randomization phase, with 54 (50%) in the allopurinol group and 54 (50%) in the trimetazidine group. Six (5.6%) individuals, 3 from each group, were lost to follow-up for the primary outcome. In the allopurinol and trimetazidine groups, the median SAQ-AF scores were 50 (30.0 to 70.0) and 50 (21.3 to 78.3), respectively. In both groups, the SAQ-AF score improved, but the median of the difference compared to baseline was lower in the allopurinol group (10 [0 to 30] versus 20 [10 to 40]; p < 0.001), as was the mean of the difference in the total SAQ score (12.8 ± 17.8 versus 21.2 ± 15.9; p = 0.014). Conclusion Both allopurinol and trimetazidine improved the control of angina symptoms; however, trimetazidine presented a greater gain compared to baseline. Brazilian Registry of Clinical Trials - Registration Number RBR-5kh98y Recently inhibitor antiischaemic anti ischaemic option.Objective optionObjective option Objective CAD. . (CAD) 201 202 betablockers beta blockers 11 1 1: 30 SAQAF. SAQAF AF (SAQ-AF) (p 005 0 05 0.0 significant phase 5 50% (50% 5.6% 56 6 (5.6% followup follow up groups 30.0 (30. 70.0 700 70 21.3 213 21 (21. 78.3, 783 78.3 , 78 78.3) respectively 10 (1 [ 2 [1 40 40] 0.001, 0001 0.001 001 0.001) 12.8 128 12 8 (12. 178 17 17. 212 21. 15.9 159 15 9 0.014. 0014 0.014 014 0.014) symptoms however RBR5kh98y RBRkhy RBR 5kh98y kh y (CAD (SAQ-AF 00 0. (50 5.6 (5.6 30. (30 70. 7 (21 78. ( 4 000 0.00 12. (12 15. 0.01 01 khy (5 5. (5. (3 (2

Resumo Fundamento Recentemente, foi demonstrado que o alopurinol, um inibidor da xantina oxidase, possui propriedades cardiovasculares e anti-isquêmicas e pode ser uma opção de agente antianginoso metabólico. Objetivo O objetivo do presente estudo foi avaliar o efeito antianginoso do alopurinol como terceiro medicamento para pacientes com doença arterial coronariana (DAC) estável. Métodos Trata-se de um ensaio clínico randomizado entre 2018 e 2020 incluindo pacientes com DAC que mantiveram angina apesar da otimização inicial com betabloqueadores e bloqueadores dos canais de cálcio. Os indivíduos foram randomizados 1:1 para 300 mg de alopurinol 2 vezes ao dia ou 35 mg de trimetazidina 2 vezes ao dia. O desfecho principal foi a diferença no domínio da frequência da angina do Questionário de Angina de Seattle (QAS-FA). Foram considerados estatisticamente significativos valores de probabilidade (p) < 0,05. Resultados Foram incluídos 108 pacientes na fase de randomização, com 54 (50%) no grupo alopurinol e 54 (50%) no grupo trimetazidina. Seis (5,6%) indivíduos, 3 de cada grupo, foram perdidos no seguimento para o desfecho primário. Nos grupos de alopurinol e trimetazidina, as pontuações medianas do QAS-FA foram 50 (30,0 a 70,0) e 50 (21,3 a 78,3), respectivamente. Em ambos os grupos, a pontuação do QAS-FA melhorou, mas a mediana da diferença em relação à linha de base foi menor no grupo alopurinol (10 [0 a 30] versus 20 [10 a 40]; p < 0,001), assim como a média da diferença na pontuação total do QAS (12,8 ± 17,8 versus 21,2 ± 15,9; p = 0,014). Conclusão Tanto o alopurinol quanto a trimetazidina melhoraram o controle dos sintomas de angina; no entanto, a trimetazidina apresentou um ganho maior em relação à linha de base. Registro Brasileiro de Ensaios Clínicos – Número de Registro RBR-5kh98y Recentemente oxidase antiisquêmicas anti isquêmicas metabólico (DAC estável Tratase Trata se 201 202 cálcio 11 1 1: 30 QASFA. QASFA FA . (QAS-FA) (p 005 0 05 0,05 10 randomização 5 50% (50% 5,6% 56 6 (5,6% primário 30,0 (30, 70,0 700 70 21,3 213 21 (21, 78,3, 783 78,3 , 78 78,3) respectivamente melhorou (1 [ [1 40 40] 0,001, 0001 0,001 001 0,001) 12,8 128 12 8 (12, 178 17 17, 212 21, 15,9 159 15 9 0,014. 0014 0,014 014 0,014) entanto RBR5kh98y RBRkhy RBR 5kh98y kh y (QAS-FA 00 0,0 (50 5,6 (5,6 30, (30 70, 7 (21 78, ( 4 000 0,00 12, (12 15, 0,01 01 khy 0, (5 5, (5, (3 (2

ABSTRACT Introduction: Telemedicine has positioned itself as a strategy to improve the quality and coverage of services, but its implementation represents a challenge for health workers. Objective: To determine the perception of the use of the Telemedicine program during the COVID-19 pandemic among midwifery health professionals. Methods: Descriptive cross-sectional study carried out on 40 obstetrics professionals working in a telemedicine program in health centers of the Ministry of Health and who were selected non-randomly. A content-validated and reliable questionnaire was used. Frequencies and percentages were estimated. Results: 45% agreed that the trainings were timely and efficient, as well as the determination of roles and profiles for a commitment to the program (50%). However, 47.5% pointed out the lack of articulation of activities in the different areas. 85% found the platform user-friendly and 70% that it had an efficient information registration system. Also, that the program provides timely access to users (60%), optimizes consultation time and number of users (52.5%), as well as more flexible timetables (55%). Conclusions: Obstetrics professionals highly value the telemedicine program, recognizing it as a useful and technologically appropriate tool for improving healthcare access and quality. Nonetheless, there is a need for better organization and articulation of this technology in professional activities.

RESUMEN Introducción: La telemedicina se ha posicionado como estrategia para mejorar la calidad y cobertura de los servicios, no obstante, su implementación representa un desafío para el personal de salud. Objetivo: Determinar la percepción del uso del programa de telemedicina durante la pandemia por la COVID-19 en profesionales de salud de obstetricia. Métodos: Estudio descriptivo de corte transversal desarrollado en 40 profesionales de obstetricia que trabajaban en un programa de telemedicina de centros sanitarios del Ministerio de Salud y que fueron seleccionados de manera no aleatoria. Se utilizó un cuestionario validado en contenido y confiable. Se estimaron frecuencias y porcentajes. Resultados: El 45 % estuvo de acuerdo con que las capacitaciones fueron oportunas y eficientes, así como la determinación de roles y perfiles para un compromiso con el programa (50 %). No obstante, el 47,5 % señalaron la falta de articulación de las actividades en las distintas áreas. Al 85 % le pareció amigable la plataforma y al 70 % que tenía un sistema de registro de información eficiente. También que el programa brinda un acceso oportuno a los usuarios (60 %), optimiza el tiempo de consulta y cantidad de usuarios (52,5 %), y horarios más flexibles (55 %). Conclusiones: El programa de telemedicina es bien valorado por los profesionales de obstetricia, la reconocen como una herramienta útil y tecnológicamente adecuada para mejorar el acceso y la calidad de la atención en salud. Sin embargo, es necesario perfeccionar la organización y la articulación de esta tecnología en las actividades profesionales.

Resumen El presente artículo determinó la factibilidad comercial, ambiental de una ruta turística en la zona centro del departamento del Huila. Para ello se determinaron los atractivos turísticos de la zona, se identificó la factibilidad comercial y se analizó la sostenibilidad ambiental del producto. La recolección de la información se realizó por medio de la Cámara de Comercio de Neiva, sede Garzón, tomando como población a los aportantes con Registro Nacional de Turismo, de los ocho municipios que conforman la zona, que ofrecían servicios de alojamiento y alimentación. La caracterización de los sitios se realizó por medio de una encuesta para trazar la ruta con el uso de Google Maps. Finalmente, arrojó como conclusión la riqueza de atractivos naturales y patrimoniales, exaltó la oferta y la demanda del inventario turístico y sumó las políticas de fomento en sostenibilidad ambiental.

Abstract This article determined the commercial and environmental feasibility of a tourist route in the central zone of the department of Huila. For this purpose, the tourist attractions of the area were determined, the commercial feasibility was identified and the environmental sustainability of the product was analyzed. The information was collected through the Chamber of Commerce of Neiva, Garzón headquarters, taking as population the contributors with National Tourism Registration, from the eight municipalities that make up the zone, who offered lodging and food services. The characterization of the sites was carried out by means of a survey to trace the route with the use of Google Maps. Finally, it concluded that there is a wealth of natural and patrimonial attractions, it exalted the supply and demand of the tourist inventory and added the policies for the promotion of environmental sustainability.

BACKGROUND. The COVID-19 pandemic highlighted the weakness of relying on in-person tuition in higher education. Massive open online courses (MOOCs) have been a successful addition to higher education. In this study, educators had to replace a planned elective in the medical curriculum with an online option during the pandemic. The roles of the competency framework of the Health Professions Council of South Africa (HPCSA) (Leader and Manager, Health Advocate, Professional, Communicator, Collaborator, Scholar, and Healthcare Practitioner) were used to guide its development. This elective emphasised the non-clinical roles of medical practitioners and was offered in 2020 and 2021. OBJECTIVES. To describe the choices of third-year medical students and time spent participating in a modified online elective in 2020 and 2021. METHODS. A descriptive cross-sectional study design was used, involving the participation of 629 medical students. Data were collected and analysed from three primary sources: registration data from LinkedIn Learning, data from the Foundation for Professional Development, and self-reported estimates by students of the average time spent on selected courses. Data included identification of the associated competency acquired. Data analysis was conducted using Python, version 3.10.11. RESULTS. The course choices of 629 students were analysed. In 2020 there were 300 participants and in 2021 there were 329. All the students had one compulsory inclusion in the elective (Management and Leadership Short Course for Undergraduate Healthcare Students). Students in both years reported spending the most average time on courses related to clinical knowledge (Healthcare Practitioner), followed by financial literacy and management (Professional), diversity management (Collaborator), and priority actions to identify and/or respond to (Health Advocate). The most popular courses related to the Leader and Manager role were around decision-making in human resources, problem-solving, and managing healthcare teams. Based on the top 10 LinkedIn Learning course selections of both cohorts, there appeared to be a preference for courses that were consistent with the role of medical professionals in practice. The most popular LinkedIn Learning course was The Six Morning Habits of High Performers. CONCLUSION. Students gravitated toward courses aligned with their role as professional doctors within the HPCSA competency framework. More studies are needed to understand how medical students develop the six non-clinical roles in the HPCSA framework and the effectiveness of MOOCs in a medical curriculum.